Antibiotic prescribing for otitis media decreased by 51% between 1995 and 2000, over a period when numerous clinical practice guidance documents were published, the analysis found.

But antibiotic prescribing for otitis media was already in steep decline when the first UK systematic review reporting the limited benefit of antibiotics for otitis media was published in 1997, and from 2000 prescribing plateaued – despite the publication of further guidance.

Study leader Professor Ian Wong, professor of paediatric medicines research at The School of Pharmacy University of London, told Pulse: ‘The usefulness of guidance for otitis media prescribing is doubtful.

'The evidence is so clear now – GPs no longer need convincing not to prescribe antibiotics. The Government needs to communicate to parents that the benefit of antibiotics is really minimal.'

The call was backed by international infectious disease experts who warned in the BMJ last week of a ‘pandemic of antibiotic resistance'.

Professor Otto Cars, from the department of medical sciences at Uppsala University in Sweden wrote: ‘The consumer may be the strongest force driving change.'

The research, published online by the Journal of Public Health, analysed data from the UK general practice research database for diagnoses of otitis media in children aged three months to 15 years and antibiotic prescribing between 1990 and 2006.